El año 2025 comienza con un panorama desafiante para las Entidades Promotoras de Salud (EPS) en Colombia.
La reciente decisión del gobierno de aumentar la Unidad de Pago por Capitación (UPC) solo un 5,36 % ha desatado alarmas en el sector. Esta cifra está por debajo de las expectativas del sector, que esperaban un incremento cercano al 17 %.
Las consecuencias de este ajuste serán notorias en la calidad de los servicios de salud, afectando tanto a los afiliados como a las propias EPS.
¿Qué es la UPC y por qué es crucial para el sistema de salud?
La UPC es el valor que el Estado asigna a las EPS por cada afiliado, con el objetivo de cubrir los costos del Plan Obligatorio de Salud (POS). Este pago es fundamental para garantizar que los servicios médicos sean accesibles para todos los colombianos, tanto en el régimen contributivo como en el subsidiado. Sin embargo, la insuficiencia de recursos ha sido una preocupación recurrente en el sistema de salud, y la situación parece empeorar para 2025.
Para 2024, la UPC experimentó un aumento del 12 %, lo que elevó el monto a 1,44 millones de pesos en el régimen subsidiado y 1,25 millones en el régimen contributivo. No obstante, este incremento no fue suficiente para cubrir el crecimiento de los costos operativos del sistema, lo que generó una gran incertidumbre para el inicio de 2025.
Un aumento insuficiente: 5,36 % en 2025
El Ministerio de Salud anunció que la UPC para 2025 aumentará solo un 5,36 %, lo que representa una cifra considerablemente menor al 16,9 % solicitado por la Asociación Nacional de Empresarios de Colombia (Andi) para garantizar el equilibrio del sistema.
Según fuentes del Ministerio, este ajuste se basó en el Índice de Precios al Consumidor (IPC) reportado en noviembre de 2024. Sin embargo, esta cifra refleja una decisión tomada en medio de lo que se describe como “poca confiabilidad y las inconsistencias detectadas en la información reportada por las EPS”.
El impacto de este bajo incremento ya ha sido evidente. Augusto Galán, director del Observatorio Así Vamos en Salud, advirtió que, con este aumento insuficiente, el sistema de salud colombiano enfrentará grandes dificultades, tanto para financiar los servicios médicos como para garantizar la cobertura adecuada para los afiliados. Para Galán, “el año 2024 terminó muy mal, y el 2025 empezará peor” debido a la falta de recursos.
Impacto en los servicios de salud
El bajo incremento de la UPC afectará directamente la operación de las EPS y la calidad de la atención. Las EPS, como Nueva EPS, Sanitas y Famisanar, ya han expresado su preocupación ante la posible escasez de recursos, lo que podría generar dificultades en la autorización de servicios, la inclusión de nuevas tecnologías y la prestación de atención en áreas clave como urgencias y consultas especializadas.
La situación de los afiliados: Crece la incertidumbre
El panorama también es desalentador para los afiliados a las EPS, que se enfrentan a un futuro incierto en términos de la calidad de los servicios que recibirán. Afiliados a EPS como Compensar han expresado su preocupación ante las medidas anunciadas, que podrían generar aún más incertidumbre sobre la cobertura y los tiempos de atención.
Las medidas del gobierno han generado una gran división de opiniones, y los expertos advierten que un sistema de salud debilitado tendrá repercusiones directas sobre la población. Si las EPS no cuentan con los recursos suficientes para operar de manera adecuada, los colombianos podrían enfrentar mayores dificultades para acceder a servicios médicos oportunos y de calidad.
El panorama para las EPS en 2025 es alarmante. El aumento de la UPC no solo es insuficiente para enfrentar los costos operativos del sistema de salud, sino que también podría generar un déficit de recursos que afecte directamente a los pacientes.
Aunque el gobierno ha justificado la medida como una forma de proteger los recursos del sistema de salud, la realidad es que los expertos señalan que este ajuste podría agravar la crisis de salud pública en el país. Con menos recursos para la operación, las EPS podrían enfrentar restricciones en la cobertura de servicios médicos esenciales, lo que afectaría a millones de colombianos.
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